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Dr. Andrew Rynne

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What causes hair fall?

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Dr. Kakkar S.

Dermatologist

Practicing since :2002

Answered : 7788 Questions

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Posted on Tue, 5 Aug 2014 in Skin Hair and Nails
Question: hair fall
doctor
Answered by Dr. Kakkar S. 10 minutes later
Brief Answer:
Hair fall treatment

Detailed Answer:
Hello and welcome to healthcaremagic

I am Dr. Kakkar. I have gone through your query and I have understood it

-I would like to know the duration of hair fall? Is it recent, sudden onset hair fall or is it long standing, gradual? Does it affect your scalp hair density?

-Obviously it is severe enough for you to compel and ask for a solution for hair fall, but I would like to know the severity of hair fall?How many hair do you lose per day? >100 or <100??Give me an approx number.

-I would like to know whether you have dandruff/ seborrheic dermatitis? If YES, I would advise that you should use a ketoconazole based antidandruff shampoo thrice weekly for 2-4 weeks and followed by once or twice weekly. If NOT suffering from dandruff, you can use any of the daily use OTC shampoos along with a good conditioner after shampoo.

Otherwise, I would keep a possibility of either Telogen effluvium OR Androgenetic Alopecia, as the cause of your hair fall and decreased hair density. In Androgenetic Alopecia the thinning is more over the crown and there is also recession of the anterior hair line(AGA)

Scalp hair grows for 2-3 years (Anagen phase) after which it enter the catagen phase (transition phase) which is followed by resting phase (Telogen phase).

Hair can prematurely enter from growth phase(Anagen) to resting phase(telogen) therefore resulting in shorter length and increased shedding. After a major stressing event like medical/surgical illness OR post delivery OR weight loss (in your case), scalp hair is prematurely pushed into resting phase (Telogen) from the growth phase (Anaphase). This phase usually starts in the third or fourth month after a major stressor and ends by six months if the stressor is removed.


Androgenetic Alopecia, is characterised by gradually progessive hair loss/thinning from the frontal scalp and crown along with gradual recession of the anterior hair line.

Androgenetic alopecia in males is commonly managed with 5% minoxidil solution is a non-specific hair growth promoter can be applied at the scalp skin in this type of hair loss, twice daily with a dropper (1ml twice daily). Minoxidil is a hair growth promoter and helps in rapid transition of hair follicle from resting phase to growth phase (Anagen).

Besides, minoxidil, an oral antiandrogen e.g finasteride is also approved for androgenetic alopecia. The mechanism of action is inhibition of the enzyme, 5-alpha reductase which is the main culprit responsible for hair thinning and miniaturization in androgenetic alopecia.

Hair fall is slow to respond and treatment may have to be continued for months to see noticeable improvements, say 4-6 months.

Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Kakkar S. 41 hours later
hair fall from single place near by the right and left ear (both side)
plz find attached image.
doctor
Answered by Dr. Kakkar S. 12 minutes later
Brief Answer:
Alopecia Areata

Detailed Answer:
Hi

I have looked at the picture. This is Alopecia Areata.

Alopecia areata is an autoimmune condition and commonly present as focal patches of hair loss, most commonly over the scalp but also on the beard, moustache or eyebrows or eyelashes. This is the most common type. Other types are alopecia totalis and alopecia universalis. In Alopecia totalis is when hair loss involves the entire scalp whereas in Alopecia universalis hair loss involves the entire body hair.

In Focal/patchy type of Alopecia Areata, in most cases, hair regrow spontaneously within 1 year (as it happened first time round with you, 5 years ago). But people often seek treatment because the bald patches are unsightly and are easily noticeable to others.

Various treatment options in Focal type of alopecia areata in order of the choice of treatment:

--Intra-lesional Triamcinolone acetonide is first line treatment in adults followed by other modalities like:
--Topical potent steroids
--Topical Minoxidil
--Topical Anthranalin
--Topical PUVA(psoralens +UVA therapy).

All of them are effective. However I prefer Intra-lesional steroid in my patients of Alopecia areata. It can be repeated after 3 -4 weeks and usually hair regrow after 2 injections, given 3 weeks apart.

I would suggest that you seek an appointment with a dermatologist in your vicinity.

Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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